scholarly journals Nurse-led care versus physician-led care in the management of rheumatoid arthritis and psoriatic arthritis (StaerkeR): study protocol for a multi-center randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Mai ◽  
Jürgen Braun ◽  
Jens-Peter Reese ◽  
Benjamin Westerhoff ◽  
Ulrike Trampisch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Patient Care ◽  
Functional Capacity ◽  
Standard Care ◽  
Controlled Trial ◽  
Treat To Target ◽  
Lower Saxony

Abstract Background In Germany, the care of patients with inflammatory arthritis could be improved. Although specialized rheumatology nurses could take over substantial aspects of patient care, this hardly occurs in Germany. Thus, the aim of the study is to examine structured nursing consultation in rheumatology practices. Methods/design In total, 800 patients with a stable course of rheumatoid arthritis or psoriatic arthritis in 20 centers in North Rhine–Westphalia and Lower Saxony will be randomized to either nurse-led care or standard care. Participating nurses will study for a special qualification in rheumatology and trial-specific issues. It is hypothesized that nurse-led care is non-inferior to standard care provided by rheumatologists with regard to a reduction of disease activity (DAS28) while it is hypothesized to be superior regarding changes in health-related quality of life (EQ-5D-5L) after 1 year. Secondary outcomes include functional capacity, patient satisfaction with treatment, and resource consumption. Discussion Since there is insufficient care of rheumatology patients in Germany, the study may be able to suggest improvements. Nurse-led care has the potential to provide more efficient and effective patient care. This includes a more stringent implementation of the treat-to-target concept, which may lead to a higher percentage of patients reaching their treatment targets, thereby improving patient-related outcomes, such as quality of life, functional capacity, and participation. Additionally, nurse-led care may be highly cost-effective. Finally, this project may form the basis for a sustainable implementation of nurse-led care in standard rheumatology care in Germany. Trial registration German Clinical Trials Register, DRKS00015526. Registered on 11 January 2019.

scholarly journals “Treat to Persist”, a deepening of the “Treat to Target”

2020 ◽  
pp. 4-6
Author(s):  
Gustavo Citera ◽  
Eduardo Mysler ◽  
Enrique R. Soriano
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Functional Capacity ◽  
Structural Damage ◽  
Primary Objective ◽  
Treat To Target ◽  
Basic Principles ◽  
Joint Decision

The treatment of rheumatoid arthritis (RA) has evolved considerably in recent years, resulting in a notable improvement in the functional capacity, quality and life expectancy of patients1. This improvement is not only due to the development of more and better medications, but mainly to the internalization by most rheumatologists of the concept of treat to target (T2T) or goal-directed treatment2. The T2T establishes 4 basic principles, which include: A) The treatment of rheumatoid arthritis must be based on a joint decision of the rheumatologist and the patient, B) The primary objective of the treatment of RA is to promote a good quality of life long-term, through the control of symptoms, prevention of structural damage, normalization of functional capacity and social participation of the patient, C) Suppression of inflammation is the main way to achieve these goals, D) Treatment towards a Objectively, evaluating disease activity and adjusting treatment accordingly, improves the outcome of RA patients.

The Nature stroke study; NASTRU - A randomised controlled trial of nature-based post-stroke fatigue rehabilitation

2019 ◽  
Author(s):  
Anna María Pálsdóttir ◽  
Kjerstin Stigmar ◽  
Bo Norrving ◽  
Patrik Grahn ◽  
Ingemar F Petersson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Perceived Value ◽  
Control Group ◽  
Post Stroke ◽  
Randomised Controlled

Abstract Fatigue is common after stroke and contributes to disability and impaired quality of life. Currently, there is insufficient evidence on the efficacy of any intervention for post-stroke fatigue. The aim of the study was to examine whether 10 weeks Nature-based rehabilitation (NRB) as add-on to standard care may improve post-stroke fatigue, perceived value of everyday occupations, function, activity and participation compared to standard care only (Clinical Trial.gov Identifier: NCT02435043, 2012/352, 05-06-2015). The study was carried out as a single blinded two-armed randomised controlled trial. Stroke survivors identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year earlier) were randomised to Standard care + NBR or Standard care only. Blinded evaluations were conducted at follow-up 8 and 14 months after randomisation. The primary outcomes were post-stroke fatigue (Mental Fatigue Scale, total score) and perceived value of everyday occupations (Oval-pd) 8 months after randomisation. About a quarter of the screened patients were eligible; half accepted to participate and 101 were randomised, mean age 67 years, 60% female. The patients with sub-acute stroke were highly compliant with the intervention. Fatigue decreased to a value below the suggested cut-off for mental fatigue (<10.5) in the intervention group but not in the control group; no statistically significant differences were found though between the groups. Conclusion: NASTRU is the first randomised study on NBR for patients with post stroke fatigue. NBR was feasible and well tolerated. The study was underpowered due to difficulties in recruiting participants. No significant differences were detected between intervention and control group. A larger RCT is warranted. Keywords: clinical trial, enriched environment, everyday occupations, horticulture therapy, quality of life.

scholarly journals Effects of a moderate-to-high intensity resistance circuit training on fat mass, functional capacity, muscular strength, and quality of life in elderly: A randomized controlled trial

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Pablo Jorge Marcos-Pardo ◽  
Francisco Javier Orquin-Castrillón ◽  
Gemma María Gea-García ◽  
Ruperto Menayo-Antúnez ◽  
Noelia González-Gálvez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Fat Mass ◽  
Functional Capacity ◽  
High Intensity ◽  
Muscular Strength ◽  
Controlled Trial ◽  
Circuit Training ◽  
Randomized Controlled
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